Richard Kunin, M.D. on Orthomolecular Psychiatry

In 1969 Linus Pauling coined the word “Orthomolecular” to denote the use of naturally occurring substances, particularly nutrients, in maintaining health and treating disease. At that time megadose niacin therapy for schizophrenia and dietary treatment of “hypoglycemia7 were the major focus of the movement. Since then Orthomolecular psychiatry and medicine have emerged as a distinct and important specialty area in medical practice.In the meantime, other medical movements have sprung up out of the public demand for Hope in the face of a worsening epidemic of cancer, heart attacks and mental illness and in response to the outcry against adverse effects of modern medical treatments and invasive diagnostic and intensive care procedures. Alternative therapies have come forward to fill the vacuum left by modern Medicine, which failed to provide effective treatments for the major epidemic diseases and in protest against Medicine’s over-reliance on pharmacology, for the drug treatments seem to have fostered the epidemic of drug-dependence which is the major epidemic of our time. The public majority were ready for a new medicine based on nontoxic, non-invasive, “natural” medicines to go with the re-discovered “natural foods”.

Holistic medicine became a rallying point for the New Medicine by putting nutrition, exercise and meditation ahead of surgery, radiation and drugs. It was an answer to the adverse effects of MegaMedicine, the cut burn and poison approach to “health”. And, since holistic medicine did not focus on basic science data, it did not force a paradigm shift in the medical establishment.

Orthomolecular, on the other hand, because it is identified with Linus Pauling, our greatest living scientist, and because it rests on vast body of research in the basic and clinical sciences, does force a major revision in medical thinking. Nutrition, which has been the stepchild of medicine and generally considered a dead issue in medicine, suddenly is at the crux of this new medical movement. No wonder then, that Orthomolecular became a buzzword to the medical establishment, who saw it only as megavitamins and judged it as quackery. By contrast, the word, Holistic became the subject of numerous symposia, journal articles, welcomed by editors eager to promote the image of modern medicine as a progressive and responsive institution. But as it gained supporters, Holistic Medicine also gained additional theories and practices, some of dubious value, some downright unscientific, Even the most broad-minded and liberal-minded editor had to recoil from permitting such things as psychic healing and kinesiology within the pages of a refereed journal.
Soon the word “Alternative, came to replace Holistic in the medical journals. Now the establishment could pick and choose individually between the various therapies that had gathered under the holistic umbrella; nutrition, biofeedback, chiropractic, acupuncture, herbalism, homeopathy, massage, hypnosis, iridology, kinesiology, astrology, psychic healing and other intuitive therapies, to name a few.
The orthomolecular movement was faltered with identity confusion and, in fact, many of our own members seem to have chosen Holistic as their preferred badge-word. This is good for the short run, I agree: it is attractive to patients and profitable while being non-controversial and safer professionally as well. In the long run, however, I think Holistic Medicine has no future. It has already lost its identity, except as a clearing house for medical novelty. Most important, because it does not identify strongly with science it has lost reliability. Meantime, Orthomolecular Medicine retains scientific reason for being: its basic science foundations of nutrition, biochemistry and clinical nutrition have grown at a prodigious rate. Megavitamin niacin therapy, which was am considered dangerous and controversial in treating schizophrenia, is now the standard of care in the hyperlipidemias. What began as megavitamin therapy now employs a broad data base and a variety of therapies applicable to numerous medical and psychiatric conditions. It is ironic that this positive growth of orthomolecular science and therapy has actually clouded the identity of the Orthomolecular movement. On the one hand we are confused with Holistic Medicine; on the other we are seen only as the avant garde of orthodox medicine In hopes of defining our true identity let me update the concept of Orthomolecular Medicine as anew medical specialty.

All of the orthomolecular practice rests on a foundation of basic science advances in biochemistry, biophysics, physiology, psychophysiology and ecology. We do not eschew drug therapy or pharmacology; but we do recognize their limitations and their potential for toxicity. Orthomolecular knowledge gives greater choice of benefits for our patients id with less risk of adverse affects.

Aside from these areas of interest, there are by now some well defined beliefs and principles that also distinguish the orthomolecular practitioner from orthodox health practitioners. These principles actually are an important part of our professional identity. Just as knowledge of science and therapeutics might be thought of as our Ego, these principles makeup our professional conscience or Superego, The desire to be in the avant garde of medical progress, to share the excitement of discovery, no doubt, is a major source of our motivational energy or libido, our medical Id, as it were. No, the love of our grateful patients, those we are privileged to heal and comfort, this must be the ultimate motive. At any rate, I think you will agree that the orthomolecular professional is a different personality, with different beliefs and values than most present-day practitioners of medical orthodoxy. Of course all physicians do cherish our Hippocratic oath, but the orthomolecular identity confers upon us additional values and beliefs. Hippocrates first rule was: “Primum non nocere,” i.e. “first, do no harm”. We in orthomolecular practice have less need for the primacy of that rule, for it is already implicit in the essence of Orthomolecular practice, which is: “put nutrition first”.

Here is a list of 15 principles that identify the spirit” of Orthormolecular Medicine:

1. Orthomolecules come first in medical diagnosis and treatment. Knowledge of the safe and effective use of nutrients, enzymes, hormones, antigens, antibodies and other naturally occurring molecules is essential to assure a reasonable standard of care in medical practice.

2. Orthomolecules have a low risk of toxicity. Pharmacological drugs always carry a higher risk and are therefore second choice if there is an orthomolecular alternative treatment.

3. Laboratory tests are not always accurate and blood tests do not necessarily reflect nutrient levels within specific organs or tissues, particularly not within the nervous system. Therapeutic trial and dose titration is often the most practical test.

4. Biochemical individuality is a central precept of Orthomolecular Medicine. Hence, the search for optimal nutrient doses is a practical issue. Megadoses, larger than normal doses of nutrients, are often effective but this can only be determined by therapeutic trial. Dose titration is indicated in otherwise unresponsive cases.

5. The Recommended Daily Allowance (RDA) of the United States Food and Nutrition Board are intended for normal, healthy people. By definition, sick patients are not normal or healthy and not likely to be adequately served by the RDA.

6. Environmental pollution of air, water and food is common. Diagnostic search for toxic pollutants is justified and a high “index of suspicion” is mandatory in every case.

7. Optimal health is a lifetime challenge. Biochemical needs change and our Orthomolecular prescriptions need to change based upon follow-up, repeated testing and therapeutic trials to permit fine-tuning of each prescription and to provide a degree of health never before possible.

8. Nutrient related disorders are always treatable and deficiencies are usually curable. To ignore their existence is tantamount to malpractice.

6. Nutrient diagnosis is always defensible because nutrient related disorders are usually treatment responsive or curable,

7. Hope is an indispensable ally of the physician and an absolute right of the patient.

Finally, let me repeat, that our rallying point and badge-word must be “Orthomolecular”, a landmark concept that conveys the genius of Dr. Pauling, who saw the need to resurrect nutrition and put it first, not last, in our science of health and disease.

This web site is neither for advertising nor dispensing of medical advice. Clients who consult with Dr. Weeks receive information in an educational context in an effort to learn about optimizing care with their local health care practitioners. Dr. Weeks formerly practiced on Whidbey Island off the coast of Washington.

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Principles That Identify Orthomolecular Medicine: A Unique Medical SpecialtyRichard A. Kunin, M.D. In 1969 Linus Pauling coined the word “Orthomolecular” to denote the use of naturally occurring substances, particularly nutrients, in maintaining health and treating disease. At that time megadose niacin therapy for schizophrenia and dietary treatment of “hypoglycemia7 were the major focus of the…